Provider Demographics
NPI:1437437563
Name:BOWLEY, ANN R (PSYS)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:R
Last Name:BOWLEY
Suffix:
Gender:F
Credentials:PSYS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1385 LARA CIR UNIT 105
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-6266
Mailing Address - Country:US
Mailing Address - Phone:321-543-8090
Mailing Address - Fax:
Practice Address - Street 1:1385 LARA CIR UNIT 105
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-6266
Practice Address - Country:US
Practice Address - Phone:321-543-8090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-22
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health